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Molecular diagnosis of egg allergy

Caubet, Jean-Christoph; Kondo, Yasuto; Urisu, Atsuo; Nowak-Węgrzyn, Anna

Current Opinion in Allergy & Clinical Immunology: June 2011 - Volume 11 - Issue 3 - p 210–215
doi: 10.1097/ACI.0b013e3283464d1b
Food allergy: Edited by Alessandro Fiocchi and Anna Nowak-Wegrzyn

Purpose of review: Allergy to hen's egg is common in infancy and childhood. Oral food challenges are often required to diagnose egg allergy, because of the limitation in the diagnostic accuracy of skin test and specific IgE to egg white. New molecular diagnostic technologies have been recently introduced into allergological research. In this article, we will review the recent literature regarding the potential value of these tests for the clinical management of egg-allergic patients.

Recent findings: Component-resolved diagnosis that can be combined with the microarray technology is promising as measurement of specific IgE antibodies to individual egg white components has been shown to predict different clinical patterns of egg allergy. Specific IgE to ovomucoid has been identified as a risk factor for persistent allergy and could indicate reactivity to heated egg. Ovomucoid and ovalbumin IgE and IgG4-binding epitope profiling could also help distinguish different clinical phenotypes of egg allergy. Particularly, egg-allergic patients with IgE antibodies reacting against sequential epitopes tend to have more persistent allergy.

Summary: Using recombinant allergens, IgE-binding epitopes, and microarrays, molecular-based technologies show promising results. However, none of these tests is ready to be used in clinical practice and oral food challenge remains the standard for the diagnosis of egg allergy.

aJaffe Food Allergy Institute, Department of Pediatrics, Division of Allergy and Immunology, Mount Sinai School of Medicine, New York, USA

bUniversity Hospitals of Geneva and Medical School of the University of Geneva, Department of Child and Adolescent, Geneva, Switzerland

cDepartment of Pediatrics, The Second Teaching Hospital, Fujita Health University, Nagoya, Japan

Correspondence to Anna Nowak-Węgrzyn, MD, Department of Pediatrics, Division of Allergy and Immunology, Mount Sinai School of Medicine, Box 1198, New York City, NY 10029, USA Tel: +1 212 241 5548; fax: +1 212 426 1902; e-mail: anna.nowak-wegrzyn@mssm.edu

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